Bronchiolitis

Paediatrics

Viral lower respiratory tract infection in <2 yr, usually RSV.

Clinical features

  • Coryza progressing to cough, wheeze, dyspnoea over 2–3 d
  • Poor feeding, irritability

Examination

  • Tachypnoea, recession, nasal flare
  • Fine crackles ± wheeze
  • Hypoxia

Investigations

  • Clinical diagnosis
  • SpO₂
  • NPA viral PCR if admitting
  • CXR only if atypical

Management

  • Supportive: O₂ to SpO₂ ≥92%, NG/IV feeds, suction
  • CPAP / HFNC if work of breathing
  • Admit if: SpO₂ <92%, apnoea, <50% feeds, RR >70, social

Clinical pearls

  • No role for β-agonists, steroids, antibiotics in typical bronchiolitis
  • Palivizumab for high-risk infants

Educational — verify locally.

WardRound

WardRound

Clinical Decisions in Seconds